AORN Electrosurgical Safety 3

Question 1

According to AORN guidelines, where should the electrosurgical pencil (active electrode) be stored when not in active use during surgery?

Accepted Answer

In a clean, dry holster or holder away from the patient and drapes

Answer

On the sterile field drape near the incision site for quick access

Answer

Handed off the sterile field to the circulator when not needed

Answer

Submerged in sterile saline to prevent accidental activation

Question 2

How should the dispersive electrode be removed from the patient at the end of a surgical procedure?

Accepted Answer

Peeled back slowly and gently, parallel to the skin, while supporting surrounding tissue

Answer

Pulled off rapidly in one motion to minimize discomfort

Answer

Soaked with saline first to dissolve the adhesive before removal

Answer

Cut around the pad perimeter with scissors before lifting

Question 3

What is 'insulation failure' in laparoscopic electrosurgery and what is its primary danger?

Accepted Answer

A break in the protective coating of the active electrode that allows current to escape and burn unintended tissue

Answer

Failure of the ESU generator to maintain a constant waveform output

Answer

Loss of contact between the dispersive electrode and patient skin

Answer

Interference from other electronic devices reducing ESU effectiveness

Question 4

What is the primary fire risk associated with using electrosurgery in an oxygen-enriched environment under surgical drapes?

Accepted Answer

Elevated oxygen concentration lowers the ignition temperature of draping materials, increasing fire risk

Answer

Oxygen reacts with the ESU electrode to produce sparks

Answer

Elevated oxygen pressure increases ESU electrical resistance

Answer

Oxygen enrichment interferes with the REM monitoring system

Question 5

Which action should the perioperative nurse take when inspecting reusable electrosurgical instruments before a case?

Accepted Answer

Inspect insulation for cracks, pinholes, or discoloration and discard instruments with any defects

Answer

Test each instrument by activating the ESU at full power and touching the tip to a metal basin

Answer

Soak instruments in high-level disinfectant for 20 minutes regardless of prior sterilization

Answer

Verify instrument function only by reviewing the sterilization log

Question 6

According to AORN's recommended practices, who is responsible for documenting the type, model, and placement site of the dispersive electrode in the perioperative record?

Accepted Answer

The perioperative (circulating) nurse

Answer

The surgeon, as it is a clinical decision

Answer

The anesthesia provider, as they manage patient monitoring

Answer

The biomedical engineer who set up the equipment

Question 7

What is the safest approach when the surgical team needs to use electrosurgery near a flammable substance such as bowel gas in abdominal surgery?

Accepted Answer

Irrigate the field with sterile water and allow adequate time for evacuation of flammable gases before activation

Answer

Increase ESU power to shorten activation time

Answer

Switch to bipolar mode and activate continuously

Answer

Apply a wet sponge over the active electrode to reduce sparking